Atrial Fibrillation

Definition

Atrial fibrillation is an abnormal heart rhythm. The heart's electrical system normally sends regularly spaced signals. These signals tell the heart muscle to contract or beat.

The heart has two upper chambers called atria. It also has two lower chambers called ventricles. Each signal starts in the atria and travels to the rest of the heart. The electrical signals from the atria are fast and irregular when you have atrial fibrillation. The atria shake instead of contract. Some signals do not reach the ventricles and the ventricles continue pumping. This pumping is usually irregular and sometimes rapid. This rhythm can reduce the heart’s ability to pump blood out to the body. Blood left in the heart chambers can form clots. These clots may sometimes break away and travel to the brain. This can cause stroke
.

Causes

In most cases, atrial fibrillation is due to an existing heart condition. Atrial fibrillation can also occur in people who do not have structural heart problems. A thyroid disorder or other condition may cause the abnormal rhythm. The cause of atrial fibrillation is sometimes unknown.

Treatment

The goals of treatment are to:

Return your heart to a regular rhythm, if possible.

Keep your heart rate close to normal.—Your doctor will tell you what your target heart rate is. In general, your resting rate should be between 60-80 beats per minute. It should be 90-115 beats per minute during moderate exercise.

Prevent blood clots from forming.

Your doctor may find another condition that is causing atrial fibrillation. This condition may be treated. In some cases, heart rhythm problems return to normal without treatment.

Treatment options include:

Medication

Drugs to slow the heart rate, such as digitalis,
verapamil, diltiazem, metoprolol, atenolol

Drugs to keep the heart in a regular rhythm, such as sotalol, propafenone, amiodarone

Drugs to prevent clot formation, such as
warfarin, dabigatran, rivaroxaban

Procedures

Cardioversion
—This procedure uses an electrical current or drugs to help normalize the heart rhythm.

Ablation
—
An area of the heart that is responsible for atrial fibrillation may be surgically removed or altered (ablated) with various techniques.

Maze procedure
and
mini-maze procedure
—The
Maze procedure
creates a pattern of scar tissue in the upper chambers of the heart. This makes a pathway for electrical impulses to travel through the heart. It also blocks the pathway for fast or irregular impulses. The Maze procedure may also be done as minimally invasive surgery (called
mini-Maze
).

Lifestyle Changes

Your doctor may recommend that you make lifestyle changes, such as:

Avoiding certain substances (eg, caffeine and other stimulants, alcohol) that may trigger another episode

Having a regular
exercise routine

Follow your doctor's
instructions
if you are diagnosed with atrial fibrillation.

Prevention

Avoid known triggers if you have risk factors for atrial fibrillation. Also, follow your doctor's advice for controlling chronic conditions, like heart disease and high blood pressure.

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Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY.
Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.